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Investigation Update on Carnival Cruise Line's Holiday

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Investigation Update – October 21, 2003

Since October 2002, the Centers for Disease Control and Prevention’s Vessel Sanitation Program (VSP) has been following or investigating several instances of gastrointestinal illness aboard cruise ships. Outbreaks of gastrointestinal illness continue to be reported throughout the U.S. and subsequently, we continue to see an increase in the number of passengers with gastrointestinal illness on some cruises.

Cruise vessels sailing to U.S. Ports are required to notify the CDC of every case of gastrointestinal illness reported to the ships’ medical staff, for each cruise. This report must be filed 24 hours prior to arrival at a U.S. port, from a foreign port. If the number of passengers or crew ill reaches 2% during the cruise, the vessel is required to file a special report. The CDC continues to closely monitor these illness reports on a daily basis. An “outbreak” of gastrointestinal illness is defined as having 3% or more of either passengers or crew reported with a gastrointestinal illness.

Cruise vessels currently being closely monitored are:

Holiday (Carnival Cruise Lines) reported the following for two recent cruises from New Orleans:

October 11-16, 2003, reported 97 of 1,653 passengers (5.8%) and 53 of 677 crew (7.8%) with gastrointestinal illness.

October 16-20, 2003, reported 12 of 1,514 passengers (0.8%) and 25 of 684 crew (3.7%) with gastrointestinal illness.

Stool samples collected from ill passengers and crew for the October 11-16, 2003 cruise have been analyzed by the CDC lab in Atlanta. Preliminary reports are positive for norovirus. Crew of the Holiday conducted extensive cleaning and disinfection of the vessel and the vessel remains in service. Daily reports are being made to the Vessel Sanitation Program.

General Information

Cruise ship travelers are reminded that simple hygienic practices, such as frequent and thorough hand washing with warm water and soap, and avoiding contact with other passengers when ill, are important measures to prevent the spread of disease.

Additional information about CDC’s Vessel Sanitation Program is available at

Information on Norwalk-like viruses is available at: and

Additional information on gastrointestinal diseases is available at

CDC protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

For more information, CDC’s Vessel Sanitation Program can be reached at